Multiple supernumerary teeth associated with an impacted maxillary central incisor: Surgical and orthodontic management

Various anomalies in the size, shape, number, structure and eruption of the teeth are often observed clinical conditions. Supernumerary teeth can be found in almost any region of the dental arch, and most of the times they are asymptomatic, and are routinely found during radiographic evaluation. The most common cause of impacted maxillary incisors is the presence of the supernumerary teeth. This paper describes a case of multiple supernumerary teeth associated with an impacted permanent maxillary central incisor in an 11-year old child along with its surgical and orthodontic management.     

Fusion of a third molar to a supernumerary tooth with an associated dentigerous cyst

During a routine oral examination of a 19 year-old Black male, a bony impaction of his mandibular left third molar fused to an inverted supernumerary tooth with a cystic cavity was found. Histologic examination confirmed the presence of a dentigerous cyst.     

Dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth

A dentigerous cyst is a developmental odontogenic cyst which develops from the reduced enamel epithelium in an impacted permanent tooth and is rarely associated with supernumerary teeth. The purpose of this article was to report the case of an 8-year-old Korean boy with a dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth and its dental management.     

Association between maxillary anterior supernumerary teeth and impacted incisors in mixed dentition

Background

Few researchers have investigated the relationship between supernumerary teeth (ST) and impacted incisors. The authors investigated the relationship between ST and impacted incisors in the maxillary anterior area in the mixed dentition.

Management of the malposition tooth that was caused by dentigerous cyst associated with impacted supernumerary tooth by using an obturator

This report presents a case of eruption guidance for an upper right central incisor with a dentigerous cyst associated with an impacted supernumerary tooth in a 5-year-9-month-old boy. A swelling was seen in the region of an upper right central incisor. Radiographic examinations showed that a well-defined cystic lesion, containing an impacted supernumerary tooth crown in it, was located between the root of the primary upper right central incisor and a permanent upper central incisor germ. Under general anesthesia, the dentigerous cyst was removed at extraction of the upper impacted supernumerary tooth. And then, a socket was kept open wound. A histopathological examination confirmed the diagnosis of a dentigerous cyst associated with a supernumerary tooth. By using an obturator, we guided eruption of an upper right central incisor with malposition that was caused by the dentigerous cyst, and observed the way of the tooth eruption for two years and seven months. The obturator was inserted in the socket directly for three months until it was closed. After that, the obturator was used as only a removable space maintainer. Eight months after the operation, the obturator was removed because the upper left central incisor began to erupt. Two years and seven months after the operation, both upper central and lateral incisors had erupted completely. In this case, the obturator was used for expectation of natural eruption of permanent incisors, space maintenance and aesthetic recovery. The permanent incisors had been able to be guided to almost correct position without traction.     

Eruption of impacted permanent upper incisors after removal of of supernumerary teeth

In a retrospective study of 63 patients, an attempt is made to determine in how many cases retained permanent upper incisors erupt after the removal of supernumerary teeth, and what predisposing and etiological factors are of importance. It proved that the eruption of a supernumerary tooth positively contributed to the chance of a spontaneous eruption of the permanent incisors. No relationship could be demonstrated between the age of a patient from whom supernumeraries were extracted, the number of supernumeraries, the extent of root formation, marked apical displacement and the chance of spontaneous eruption of the permanent incisors. It also proved that only in 1 out of 2 children did spontaneous eruption occur after removal of the supernumeraries. It therefore seems advisable to provide all impacted upper incisors with a cervical ligature of bracket with twined wire sling during the first operation in order to create the possibility for orthodontic traction if spontaneous eruption of the incisor does not occur, and thus to prevent a second operation for the child.     

Conservative treatment of dentigerous cyst associated with primary teeth

Dentigerous cyst is the most common odontogenic cyst. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds or, under certain circumstances, displaced tooth buds. Buccal bony expansion is the most common clinical feature. Several treatment modalities have been mentioned in the literature for management of dentigerous cysts. The purpose of this article was to report an extensive right mandibular dentigerous cyst on a 10-year-old boy. Marsupialization was chosen to preserve the permanent tooth bud and a denturelike obturator was then provided for space maintenance and masticatory function. Long-term follow-up revealed good healing of the bony lesion with converted tooth eruption.     

Correction of a superiorly displaced impacted canine due to a large dentigerous cyst.

One of the more difficult situations dealt with by orthodontists is the treatment of impacted maxillary canines. This case report describes an impacted canine positioned near the floor of the orbit that was brought into a normal position. Diagnostic records revealed impacted and displaced teeth resulting from a large radiolucent lesion. The patient was referred to an oral surgeon. The lesion was diagnosed as a dentigerous cyst and marsupialized over 12 months. After decompression of the cyst, the impacted teeth were exposed and orthodontically brought into their proper position.     

Bilateral fusion of the maxillary central incisors to supernumerary teeth: report of case

A rare occurrence of bilateral dental fusion is reported. An alternative to conventional treatment is described in which the supernumerary teeth are separated and maintained as part of the anterior complement of teeth.     

A retrospective study of unerupted maxillary incisors associated with supernumerary teeth

We retrospectively reviewed the clinical records and radiographs of 100 patients who had had supernumerary teeth removed. Their mean (SD) age was 9 years 3 months (2). The 100 patients had a total of 127 unerupted maxillary incisors associated with supernumerary teeth. The supernumerary tooth was removed without exposure of the permanent tooth more often among the 79 younger children (aged 10 years or less) (SND=3.52, P<0.01), and when the incisors were less mature (Cvek classification 1, 2, and 3) (SND=5.27, P<0.01). Of these incisors with immature roots that were treated conservatively, 60 (72%) erupted and 24 (28%) required further operation. Of the mature incisors treated conservatively, 10 (63%) required further operation. In this study, almost three-quarters of immature incisors erupted spontaneously after removal of the associated supernumerary teeth. Over half of the mature teeth required further operation. Mature teeth should be exposed with or without bonding at the time of removal of the supernumerary teeth.     

A retrospective evaluation of the eruption of impacted permanent incisors after extraction of supernumerary teeth

AIMS: Delayed eruption of teeth may be caused by the presence of one or more supernumerary teeth. The purpose of this study was to evaluate findings, predisposing factors and differentiate different techniques used that affect the outcome following removal of supernumerary teeth. A comprehensive literature review was also undertaken. METHODS: A longitudinal retrospective study was carried out at the Royal Liverpool Children's Hospital. A total of 120 patients were identified from the general anesthesia records that had supernumeraries extracted. Only 43 cases had delayed eruption of teeth caused by supernumeraries. The pre and post extraction record data collected were the gender, radiographic assessment, position of the supernumerary, age at time of referral and extraction of the supernumerary, age at time of eruption of the impacted tooth and the orthodontic and surgical management. RESULTS: The mean age of referral was 9.1 years with a male to female ratio of 4.4:1. There was a greater predilection for supernumeraries to be on the left side and be positioned palatally. Tuberculate type supernumeraries were the most frequent followed by the conical type. Spontaneous eruption of the impacted tooth occurred in 49% of cases. Eruption of the impacted tooth within eighteen months following removal of the supernumerary was observed in 91% of cases. The chronological age and space availability were the two factors that were critical in determining if eruption was spontaneous following removal of the supernumerary. CONCLUSIONS: The findings of this study reiterates the fact that given early referral, sufficient space and time, the majority of teeth prevented from erupting by a supernumerary tooth would erupt spontaneously following removal of the supernumerary alone. Randomized multi-centre prospective studies are suggested.     

105例上颌中切牙埋伏阻生的类型及处理

个别上中切牙埋伏在临床上并不少见［１］。因其在功能及美观两方面的作用，故在治疗过程中，须尽可能地保留该牙。作者在１９８１～１９９４年间共收治１０５例埋伏上中切牙，对其临床表现进行了归类、分析，现报道如下。临床资料１一般资料患者１０５例。男４０例，女６...     

Genetic basis of dentigerous cysts associated with supernumerary teeth: A narrative review

In the present study, we sought to: (a) analyze the p53 gene status in dentigerous cysts (DC) associated with supernumerary teeth (ST) in a pair of siblings with ST, of whom one developed a DC; and (b) conduct a narrative review of the literature on ST associated with DC. Blood samples were obtained, and the isolated DNA was used to amplify exons 4‐8 of the p53 gene using specific primers, and subsequently sequenced. No mutations were identified in the coding regions of the p53 gene. A review of the literature revealed a prevalence of DC associated with ST to be as high as 13.6%, and that 83% of the case reports performed enucleation of DC and removal of ST. Dentigerous cysts associated with ST in one sibling demonstrated that variations in phenotypes exist, and the absence of mutations cannot eliminate the potential influence of genetic risk factors.     

Spontaneous eruption of impacted maxillary incisors after surgical extraction of supernumerary teeth: a systematic review and meta-analysis

Objectives

To evaluate the spontaneous eruption potential of impacted human permanent teeth localized in the anterior part of the maxilla, after the surgical extraction of obstacles in their eruption pathway, by means of a systematic review and meta-analysis.

Materials and methods

A systematic literature search was carried out to locate studies reporting on the percentage of anterior permanent teeth erupting after surgical removal of the obstacle, without other interventions. Eruption potential of impacted teeth was calculated using a random-effects meta-analysis. Information about the sex proportion, follow-up duration, age and years during which the study was carried out was used for subgroup analyses.

Results

A total of twelve studies were included, with a total sample size of 960 cases and a follow-up period of up to 36 months. The results show that more than 65.5% of impacted teeth erupt spontaneously following surgical extraction of the obstacle, with an odds ratio of 4 (95% CI 1.9, 8.2) (p < 0.001) favouring spontaneous eruption.

Conclusions

When faced with an impacted maxillary anterior tooth, surgical extraction of the obstacle can lead to spontaneous eruption of the impacted tooth in the majority of cases, with better success with a longer follow-up for up to 3 years.

Clinical relevance

Based on the present meta-analysis, clinical recommendation would be to surgically remove the obstacle impeding the eruption of a maxillary anterior permanent tooth and wait for the eruption of the tooth for a period of 12–36 months, depending on the age of the patient.